Second Monrovia death reported in unexplained Liberia illness cluster

Health officials in Liberia have reported a second death in Monrovia linked to an unexplained illness cluster in people who attended the funeral of a religious leader in Greenville, located about 4 hours' drive south of the country's capital in Sinoe County, according to local media reports.

Frances Kateh, MD, Liberia's deputy health minister and chief medical officer, told the Monrovia-based Daily Observer that the latest death raises the cluster's fatality count to 12. The new case raises the overall cluster total to 21. He said tests have repeatedly ruled out Ebola and Lassa fever.

A media report from Liberia News Agency (LINA) yesterday said the second Monrovia death involved a female contact of a man who also died after returning from Greenville. The report did not say if the woman had also traveled to Greenville, so it's unclear if her illness represents a secondary case from an infectious cause.

Tarik Jasarevic, a spokesman with the World Health Organization (WHO), told CIDRAP News today that a field investigation team lead by Liberia's health ministry but supported by the US Centers for Disease Control and Prevention and the WHO is still trying to determine of the cluster is related to ingestion of contaminated food or drinks served at funeral events in Greenville around Apr 22.

He added that investigators are also exploring if any contaminated food or drinks were taken to other locations by any funeral participants.

"Other possible causes of this cluster are not being ruled out at this stage, and so the investigation continues to follow all leads, including collecting specimen for full range of bacteriological, virological, and toxicological analysis," Jasarevic said.May 2 Daily Observerstory May 1 LINA story

Postmortem findings on 7 Zika infants show microcephaly, other issues

In a study yesterday in Emerging Infectious Diseases, results of postmortem examinations of seven babies born in Ceara, Brazil, highlight microcephaly and other major defects. The babies were likely exposed to Zika virus through their mothers during the first trimester of pregnancy in early 2015.

The babies died 30 minutes to 6 days after delivery, and cerebrospinal fluid tested positive for Zika virus. Only one of the seven neonates suffered from intrauterine gross restriction, but six had low brain weight for their gestational age.

Six of the babies also had obvious microcephaly, and all had several neurologic malformations, including calcifications in the brain stem and thinning of the parenchyma.

Besides brain malformations, all seven neonates had pulmonary hypoplasia, and several had small lungs for their respective gestation ages. The authors concluded that the lungs were damaged when the central nervous system was attacked by the Zika virus.

"In addition, variable liver damage, a finding commonly seen with infection by other flaviviruses, was found in these neonates," the authors concluded. May 1 Emerg Infect Disstudy

Pathogenic bacteria identified in Germany using DIY CRISPR kit

The European Centre for Disease Prevention and Control (ECDC) said that in March of this year, Germany reported the detection of pathogenic organisms in a do-it yourself Bacterial Gene Engineering CRISPR Kit. Some of the organisms were antibiotic-resistant.

"The kit is sold over the Internet, targeting non-professional microbiology hobbyists. The detection of the pathogenic microorganisms was made as part of the control implemented by local health and food safety authorities," the ECDC report said. The kit was labeled safe for at-home use.

The genome editing kit is manufactured in the United States, and the ECDC said it does not suspect to be in wide use in Germany or elsewhere in Europe.

"The risk of infection by the contaminating strains in the kit is low for the users of the kit, assuming that they are healthy," the ECDC concluded. "The contribution of the kit to the burden of antimicrobial resistance in the EU/EEA population and environment is marginal and the risk associated with the kits is considered very low."Apr 29 ECDC report